And the winners in medical design are…

20 Feb And the winners in medical design are…

I just returned from Los Angeles, where I served as a judge for an industry award contest. It wasn’t the Oscars.
Instead, 14 other jurors and I were locked in a conference room at the Sheraton at Los Angeles International Airport. Over three days, we carefully and diligently selected the winners of this year’s Medical Design Excellence Awards (MDEA).
While the Academy Awards get much more recognition, the MDEA winners may very well save your life some day.
The actual results are confidential, and the overall winners will be revealed in the April issue of Medical Device & Diagnostic Industry (MDDI). The gold and silver awardees will be announced at the annual Medical Design & Manufacturing East (MD&M East) conference from June 11 to 14 in New York City.
Unfortunately, this column will not tell you who won. Without giving specific examples, I do think it would be of interest to see what caught the judge’s eyes and what it takes to be an MDEA winner. Such considerations have important implications for future trends in the medical device industry.
Gut feeling
The 15 judges came from a wide spectrum of background and interests in the medical device and equipment industry. They fall into three major groups: engineers, designers, and clinicians. Many of them shared experience in multiple sectors. We had the whole range from leading academicians to hardcore industry veterans.
The rigorous process of cross-validation and multiple voting, along with the various quantitative assessments, made this as objective a process as possible. Admittedly, pure objectivity is never possible and information often is incomplete. Some entries came without the actual equipment. It’s difficult, for example, to ship an MRI machine.
Complete evaluations are often not possible. This was evident in those products incorporating complex software, whereby an evaluation of all possible bugs and algorithmic scenarios was not feasible. The extensive experience of the judges comes into play and gut feelings – what Malcolm Gladwell calls “rapid cognition” – also figured into the assessments.
Overall, we were very impressed with the level of innovation and are comfortable with our final assessments.
We had fairly uniform agreement on the winners and those who needed to try harder next time. In having the opportunity to see such a wide swath of medical innovation, we also had a chance to observe some very interesting and important trends. Without referencing specific products, that’s what I’ll share with you.
Design counts
The success of the iPod has more to do with design than any technological innovation.
While MP3 players certainly existed before the iPod, elegant and simple design is what has made it the predominant MP3 player in the market. This reawakening of design consciousness represents a socio-cultural trend that is definitely playing out – albeit perhaps delayed – in the healthcare industry as well.
Because safety and efficacy always have been pre-eminent, pure design considerations often have been secondary. As many people are aware, the result has been hospital equipment that is, frankly, ugly and often unfriendly to users.
While hospital and clinic architecture has advanced and we can describe some medical buildings as beautiful, the “innards” and the equipment are often forbiddingly unaesthetic. By and large, that has been okay so far. However, with the latest crop of MDEA entrants, we’re seeing an increasing emphasis on functional aesthetics.
For example, we saw smooth edges that fit better in the hand and attractive packaging that makes it easy to retrieve instruments or devices. We’re going to see more of those in hospitals. That’s a good thing.
Back to the basics
In line with the increasing emphasis on design, we observed some of the best products leveraging very basic geometrical and technical elements. While nobody gets an award for inventing the wheel, adding a wheel to something – simple as it may seem – can render an otherwise mundane or unwieldy product much more useful and innovative.
The ancient Greeks believed the sphere was the perfect form in three dimensions. It’s remarkable what one can do with that fact. “Back to the basics” often was a successful formula.
And while resurrecting basic elements can be a very powerful component of compelling design, we did see a continued flourishing of devices and equipment embedded (or integrated) with electronics and its accompanying software. This is a trend that everyone is aware of – just look under the hood of your car – but was surprisingly evident in a great many of the MDEA candidates.
We saw this in the fanciest imaging technologies, as well as in much more basic packaging products. It is clear that medical devices are becoming increasingly based on informatics, and this trend will certainly continue. That being said, some important takeaways should be noted.
The phenomenon of “software for software’s sake” (which some say helped contribute to the dotcom bust) definitely did not score high points. Over-engineered software – the type we often see on desktop computers today – is always frowned upon but especially in mission-critical applications such as healthcare.
Additionally, the trend toward increasingly proprietary electronic systems in which one company’s devices cannot communicate with others was also problematic.
While we realize this is not necessarily the fault of the manufacturer because such standards often do not yet exist, those systems that at least made an attempt at a more open platform framework were considered to be less functionally limited. Open standards for healthcare IT will no doubt increasingly be the case in the future.
Companies that wish to design successful devices should keep this in mind.
Simplicity rules
While electronics have increasingly infiltrated medical equipment and devices, simplicity of design and use was a key criterion for the judges. Healthcare, itself, is intrinsically very complex. Devices playing just one role in the entire care process must be as simple as possible.
Eager engineers often throw up their hands in exasperation at seemingly highly trained clinicians who complain about having to twist an extra knob or use an extra tool. This is the thought that probably comes to mind: “With all that education, you still can’t flick a switch?”
Apart from the additional complexity, consider the common scenario when that “magic” extra surgical device falls on the floor and is no longer sterile. What do you do then?
That ingenious little extra step has now converted the smooth operation into the proverbial “dog-and-pony show.” That’s not good for clinicians or patients. The judges recognized that you could be brilliant without being complicated. Albert Einstein said: “Everything should be made as simple as possible, but not one bit simpler.”
Safety is key
In a previous column, I wrote about the increasing emphasis on safety both in pharmaceuticals and devices. This trend was very evident in this latest round of the MDEA, both in terms of innovations that emphasized safety improvements as well as in safety being an important judging criterion.
To some extent, the safety element integrates the previously outlined concepts of aesthetic design, simple execution, and intelligent process. For example, devices in which the software element helped to minimize or even eliminate errors scored very highly among the judges.
On the other hand, devices that piled on additional functionality sometimes raised safety concerns as additional and more complex functions provided more opportunity for error.
Despite all the innovation we’ve seen, the medical device industry is fundamentally quite conservative.
This conservatism is largely driven by the premium on safety.
As such, radical innovation – particularly where it may compromise simplicity and safety – was not necessarily a characteristic of the MDEA winners. It should also be noted that all submissions must have had regulatory approval at least somewhere in the world. This requirement obviously eliminated some of the more futuristic innovations.
Michael Rosen, my fellow MidwestBusiness.com columnist, wrote an excellent column last week on the deconstruction of Big Pharma, and he said economic imperatives are driving secular change in the industry. For reasons we won’t go into here, a dearth of innovation, as evidenced by the well-known sparse product pipelines in the industry, also is to blame.
As we saw in this round of the MDEA, innovation is alive and well in the medical device industry. In addition to the economic shifts occurring, this innovation also will contribute to the shift in power and market capitalization we’ve seen in pharma and the device industry.
Learned losers
In a previous column, I wrote about publication bias and how it influences, in often-unforeseen ways, medical and investment decisions. We can expand on that theme by adding the phenomenon of “award bias.” In award bias, the natural focus is on the winners. By corollary, no company advertises that they did not win an MDEA accolade. Still, I think we have as much to learn – perhaps even more so – from the losers.
Was the losing product not simple enough? Did it have a potential safety flaw? Was it functionally limited because it was too proprietary?
Although I don’t mean to be glib or platitudinous, I would hope that such industry awards (this includes the Oscars) are more than just about “winners” and “losers,” but about the entire industry engaging in continuous learning. An industry that doesn’t learn will ultimately fail, and in that case, there will be no winners.
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